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llI'h RCC 4121771 ,
Iffa~80;25~24 COMMOND~~~T'-JE~TOo': :E~~N~~YLV~NIA
afi4;;2>~'>; OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
11:-'"
5 RECEIVED
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.........--.....--....--...--.J.rJiREE .BU:N:DItED' TWENTY-SEVEN &
511100.....................
dollars
representing Pennsylvania Inheritance or
Snelbdt!rMoCa1eb & El:tck~:t'. Att t. Estate Tax due from the fallowing estate,.
Cea6Ua J. S an
44 Wdt Main Street
MAahanicSbufR,Pa.
17055
1..2..1978
21"18..21
Dote of Death
June e6~191B
MICHAEL c. SEMYAN
MICHAEL C. SEMAN,a.k.a..
Date of Payment
Nome of Decedent
i County cumberland
arks:
IYrn~~[L~@mlYrn SEAL
NOTE: This Triplicete Receipt to be retained for eudit PUrpOS88.
2%Taxon
$
$
6%Toxon
$
$
15% Tax on $
$
% Tax On $
Estate Tax, Act of
May 7, 1927
$
$
f
TOTAL TAX CREDIT
less five percentum of tax if
paid within three months after
date of death
Plus interest at the rafe of
_%from
to
327.57
$
$
$
II
I
I
TOTAL AMOUNT PAID
$
I
,
I!
Received by
NOTE: In accepfing the transfer inheritance t01l- on Future estates, prior to the deoth 01 the lile
lenant or tenant for years, as evidenced by this rec.eipt, it is understood that the Commonweolth shall
nal be precluded or prevented lrom hereoher assQssing oddiiional inheritance lax. at the death of the
life tenant en tenant Far years whenever II appears that such odditionol tax moy bel legolly due and
colleclible for any reason whatsoever.
RiehM' i~tu~.I'.on
Re~l.tel' ofWll1a
(Title)
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